Laserfiche WebLink
LAND USE PERMIT APPLICATION—Burnett County WI a b <br /> Permit Fees: <br /> c 'n <br /> Dwelling/Principal Building-Single Family $300 Addition to Dwelling/Principal Building-Single Family 200 a' <br /> Dwelling/Principal Building-Multi-Family $300 Addition to Dwelling/Principal Building-Multi-Family <br /> CommerciaUlndustrial Building $300 Addition to Commercial/Industrial Building $200 <br /> Accessory Structure/Addition to Acc.Structure $150 Accessory Structure or Bunkhouse $250 <br /> Accessory Structure-Commercial Cl &Il) $200 Addition to Accessory Structure-Commercial Cl &I1 $200 <br /> Deck/Stairs/Patios $125 Gazebo(WI Stat 59.6920v)) $350 c <br /> Camping Unit $100 Filling/Grading $150 <br /> Permit Extension Valid for one year-Only 1 Allowed) $100 c V'` <br /> *NOTE:After-the-fact(when no permit is obtained prior to construction)is three times the normal fee. „ <br /> *Communication Towers&Signs require a different application form,see corresponding application and fees. <br /> *Items not listed above will be treated as accessory structures,such as:pergolas, landscaping,retaining walls. <br /> n <br /> m <br /> Applicant Complete All Sections Below This Line t �. <br /> z <br /> Applicant's Name:� �/ j � I/) �/1E jj� �/�'� �/ <br /> Applicant's Mailing Address: 1-7 '3[-1 PAr� L\L � \y p/ l► 'I1�)p <br /> City State Zip o b <br /> Applicant's Telephone Number: q <br /> Applicant's Email: �"6M �1^�,.) 11'6 �� �.i'g1lSccaZf5pf1 CSM i 1 <br /> w <br /> m <br /> If staff has a question about this application how do you prefer to be contacted? Check one below. <br /> ❑Letter ❑Phone Email °v "L <br /> / 0 <br /> Legal Description: <br /> Lot#: CSM Vol. Pg. OR v <br /> y <br /> Lot#: Block#: Subdivision Name: OR <br /> Gov't Lot#: OR 1/4 1/4 <br /> f <br /> Section#: '3A- Town#: A4A N Range#: Ib W Town of <br /> *Attach additional page if neededfor lengthy description OR attach a copy of the deed OR attach tax system property page.* `3 <br /> Parcel#(24 digits): <br /> Tax ID#(1-5 digits): <br /> z � <br /> Q <br /> Property Site Address#: A,, <br /> Road Name:-(JJ�V�r R� City: UA-013L V-P�l <br /> TYPE OF PERMIT(S): Check appropriate box/boxes Fee Rec�l�`� <br /> ❑ Single Family Dwelling ❑ Multi-Family Dwelling ❑ Filling/Grading ❑ Commercial Building <br /> Single Family Addition ❑ Multi-Family Addition ❑ Deck/Patio ❑ Commercial Addition <br /> 0 <br /> ❑ Stairs ❑ Acc. Structure(Non-bunkhouse) ❑ Bunkhouse ❑ Commercial Acc. Structure N <br /> ❑ Permit Extension ❑ Gazeboo-WPI Stat 59.6992(iv) El Camping Unit L3 Commercial Acc.Addition C J V D <br /> Proposed Structure/Addition Use: CACpj N 400 rn aj <br /> > Z � <br /> (Home/Cabin;Commercial Business;Bedroom;Deck;etc.) *4 D <br /> Building Contractor: 5tr� - �u <br /> �/ n N <br /> Anticipated Start Date: - �(7y"1 ` lY1 m, O o <br /> Page 1 of 4 Z <br /> Burnett County,WI Land Use Application—Rev 3/2015 <br /> z <br /> m <br /> a <br /> m <br />